LGBTQIA+ Health Care Services FAQs

Blue Cross offers robust coverage, including medically necessary procedures for gender affirmation and generous fertility preservation and infertility benefits. For members whose gender identity differs from their assigned sex at birth, we traditionally cover:

• Genital reconstruction
• Facial feminization or masculinization
• Breast augmentation
• Mastectomy
• Electrolysis and/or laser hair removal
• Feminizing or masculinizing speech therapy and voice training services
• Vocal cord surgery for transfeminine members
• Fertility preservation
• Puberty blockers and gender-affirming hormone therapy (at the discretion of the treating provider)
• Mental health services

Learn more about our gender-affirming benefits and coverage or call 1-888-243-4420.

*Your benefits and coverage may vary. Please see your subscriber certificate for details about your plan coverage.

Laser hair removal is a common procedure for transgender and non-binary individuals who want to reduce or remove unwanted hair during their transition. Here are some options and considerations:

• Laser hair removal: This method uses laser light waves to target the melanin in the hair follicle. The U.S. Food and Drug Administration (FDA) considers it to be a permanent hair reduction method.
• Electrolysis: The FDA considers electrolysis to be a permanent hair removal method. This method uses a small probe tip that is inserted into each individual hair follicle and delivers an electric current. Depending on which current is used—direct or alternating—the follicle is destroyed by either a chemical reaction or localized heat.

Common Treatment Areas:

• Facial Hair: Common for trans women and non-binary individuals seeking a more feminine appearance.
• Body Hair: Includes chest, back, legs, arms, and other areas as desired.
• Genital area: Important for individuals planning genital reconstruction surgery.

Blue Cross Coverage

We provide coverage for electrolysis and/or laser hair removal performed by a licensed provider on the skin where genital reconstruction surgery will be performed.

Hair Removal Considerations

• Skin Type and Hair Color: The effectiveness of laser hair removal depends on skin type and hair color. Consultation with a professional can determine the best laser type.
• Number of Sessions: Multiple sessions are required for optimal results. Typically, 6-10 sessions are spaced out 4-6 weeks apart.
• Cost: Electrolysis / laser hair removal can be expensive. Some insurance plans may cover it as part of gender-affirming care.

When you meet with a surgeon who can perform your gender-affirming surgery, you’ll most likely discuss the following: 

• An overview of your medical history 
• Your goals and expectations for the surgical procedure 
• Your surgical options 
• Having a physical assessment and procedure recommendations from a surgeon 
• The potential risks and complications 
• The surgical process 
• Recovery accommodations 
• Costs and insurance coverage

If applicable. *Some surgeons do not accept insurance.

All gender-affirming surgeries must meet ALL of the following criteria to be considered MEDICALLY NECESSARY:

• Person is over the age of 18
• Person has been diagnosed with gender dysphoria (ICD-10 codes F64.0-F64.9 gender identity disorder), and meets ALL the following indications:
  • Person desires to live and be accepted as a member of another gender other than one’s assigned sex, typically accompanied by the desire to make the physical body as congruent as possible with the identified gender through surgery and hormone treatment.
  • Person’s new gender identity should be present for at least 6-12 months.
  • Person has a consistent, stable gender identity that is well documented by their treating providers, and when possible, lives as their affirmed gender in places where it's safe to do so.
  • The gender dysphoria (ICD-10 codes F64.0-F64.9 gender identity disorder) isn't a symptom of another mental disorder.

These codes allow providers to appropriately submit claims to Blue Cross to be reimbursed for their services.

You can find providers who offer gender-affirming care by:

• Viewing our list of inclusive providers
• Use our Find a Doctor tool and contact the selected provider to see if they offer gender-affirming care.
• Call Member Services at 1-888-243-4420.

There are three ways that you can check if a specific provider accepts your health plan:

• Sign in to MyBlue and use the Find a Doctor tool to search for the provider. The tool will let you know if the provider is in our network. 
• Call us at 1-888-243-4420.
• Call the provider’s office and ask if they accept your insurance.

• All gender-affirming surgeries require prior approval except hysterectomies and orchiectomies.
• If you need more than 12 electrolysis or laser hair removal appointments.
• Members with HMO and HMO Blue New England (HMPNE) plans and who are going out of network must also have an approved Managed Care out-of-network requests on file for any out-of-network providers

• Fax the authorization to the fax number on this form or call 1-888-243-4420.
• If you’re an HMO Blue New England (HMPNE) member with an out-of-state primary care provider (PCP), the authorization typically must go through the state where the PCP is located instead of going through Blue Cross. We’ll ask the PCP to send us the request only if they say the request was denied by the local Blue Cross where the PCP is located.